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Ms. Jenefer June Southwick, PA-C
Medical Physician Assistant in Moose Lake, Minnesota
NPI 1912122797

Jenefer June Southwick is a Medical Physician Assistant based in Moose Lake, MN and is specialized in Medical. Jenefer June Southwick practices in Moose Lake, MN and has the professional credentials of PA-C. The NPI Number for Jenefer June Southwick is 1912122797 and holds a License No. 7977 (Minnesota).

The current practice location address for Jenefer June Southwick is 1000 Lakeshore Dr, Moose Lake, MN and can be reached out via phone at 218-485-5050 and via fax at 218-485-5008.

Location: 1000 Lakeshore Dr, Moose Lake, MN, 55767-9449
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Provider Profile Details
NPI Number
1912122797
Provider Name
Jenefer June Southwick
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
1000 Lakeshore Dr, Moose Lake, MN, 55767-9449
Phone Number
218-485-5050
Fax Number
218-485-5008
Provider Enumeration Date
04/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7977 01 MN STATE LISCENSE
institution
Provider Business Practice Location Address Details
Address
1000 Lakeshore Dr
City
State
Zip
55767-9449
Phone Number
218-485-5050
Fax Number
218-485-5008
person
Provider Business Mailing Address Details
Address
1000 Lakeshore Dr
City
State
Zip
55767-9449
Phone Number
218-485-5050
Fax Number
218-485-5008
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
7977 (Minnesota)
Definition
Definition to come...
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